Outcome of hospitalization for COVID-19 in patients with interstitial lung disease: an international multicenter study
Drake, TM; Docherty, AB; Harrison, EM; et al.Quint, JK; Adamali, H; Agnew, S; Babu, S; Barber, CM; Barratt, S; Bendstrup, E; Bianchi, S; Castillo Villegas, D; Chaudhuri, N; Chua, F; Coker, R; Chang, W; Cranshaw, A; Crowley, LE; Dosanjh, D; Fiddler, CA; Forrest, IA; George, PM; Gibbons, MA; Groom, K; Haney, S; Hart, SP; Heiden, E; Henry, M; Ho, L-P; Hoyles, RK; Hutchinson, J; Hurley, K; Jones, MG; Jones, S; Kokosi, M; Kreuter, M; Mackay, LS; Mahendran, S; Margaritopoulos, G; Molina-Molina, M; Molyneaux, PL; O'Brien, A; O'Reilly, K; Packham, A; Parfrey, H; Poletti, V; Porter, JC; Renzoni, E; Rivera-Ortega, P; Russell, A-M; Saini, G; Spencer, LG; Stella, GM; Stone, H; Sturney, S; Thickett, D; Thillai, M; Wallis, T; Ward, K; Wells, AU; West, A; Wickremasinghe, M; Woodhead, F; Hearson, G; Howard, L; Baillie, JK; Openshaw, PJM; Semple, MG; Stewart, I; Jenkins, RG
Date: 2 October 2020
American Journal of Respiratory and Critical Care Medicine
American Thoracic Society
Rationale: The impact of COVID-19 on patients with Interstitial Lung Disease (ILD) has not been established. Objectives: To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age, sex and comorbidity matched population. Methods: An international multicenter audit of patients ...
Rationale: The impact of COVID-19 on patients with Interstitial Lung Disease (ILD) has not been established. Objectives: To assess outcomes in patients with ILD hospitalized for COVID-19 versus those without ILD in a contemporaneous age, sex and comorbidity matched population. Methods: An international multicenter audit of patients with a prior diagnosis of ILD admitted to hospital with COVID-19 between 1 March and 1 May 2020 was undertaken and compared with patients, without ILD obtained from the ISARIC 4C cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished IPF from non-IPF ILD and used lung function to determine the greatest risks of death. Measurements and Main Results: Data from 349 patients with ILD across Europe were included, of whom 161 were admitted to hospital with laboratory or clinical evidence of COVID-19 and eligible for propensity-score matching. Overall mortality was 49% (79/161) in patients with ILD with COVID-19. After matching ILD patients with COVID-19 had higher mortality (HR 1.60, Confidence Intervals 1.17-2.18 p=0.003) compared with age, sex and co-morbidity matched controls without ILD. Patients with a Forced Vital Capacity (FVC) of <80% had an increased risk of death versus patients with FVC ≥80% (HR 1.72, 1.05-2.83). Furthermore, obese patients with ILD had an elevated risk of death (HR 2.27, 1.39−3.71). Conclusions: Patients with ILD are at increased risk of death from COVID-19, particularly those with poor lung function and obesity. Stringent precautions should be taken to avoid COVID-19 in patients with ILD. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Institute of Health Research
College of Medicine and Health
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Except where otherwise noted, this item's licence is described as Copyright © 2020 by the American Thoracic Society . This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0